Biller, Consolidated Business Office - FT

Improving Lives Together

Magruder Hospital offers competitive wages with a comprehensive benefit package available to both full-time and part-time employees. We provide a full health plan and generous time off that includes Holidays, Vacation, Sick, Personal, and even your Birthday! Our culture and family friendly work environment truly set us apart- apply today for an opportunity to join our team and help serve this great community!

Bills insurance companies for all hospital and hospital employed provider bills; pursues collection of all claims until payment is made by insurance companies; and performs other work associated with the billing process.

• Secures needed medical documentation required or requested by third party insurances.
• Follows up with third party insurance carriers on unpaid claims until claims are paid or until only self-pay balances remain.
• Resolves patient billing inquiries and problems, follows up on balances due from insurance companies and patients within their daily work list.
• Enters data electronically to process charges, payments. denials and adjustments.
• Understands the Revenue Cycle.
• Completes and submits claims for payment, electronic or hard copy, including initial billing, all insurance re-billing, and secondary or subsequent billings.
• Responsible for accuracy and third-party compliance in all aspects of billing activities, in particular relating to clinical attachments, CPT coding, occurrence, condition and value codes, pre-certification, contractual adjustments or required forms.
• Understands the relationship of timely and thorough claims follow-up to assist in the reduction of days in accounts receivable and payer turn around.
• Maintains a thorough understanding of all HMO, PPO, or managed care contractual relationships and able to determine if correct payments and adjustments were made.
• Ability to identify a credit balance account and make the correct determination as to whom/where the credit balance should be refunded or transferred.
• Reports all repeated errors or omissions of patient insurance and demographic information to the manager.
• Corrects all claims edits or errors promptly and before submission.
• Prioritizes issues and workload effectively.
• Works effectively as both a team member and one on one.
• Ability to communicate effectively both verbally and in writing.
• Maintains diagnosis follow-up procedure and working relationship with Health Information Coders and all other departments hospital wide.
• Assist with researching posting problems when needed.

• Complies with federal, state, and local legal requirements by studying existing and new legislation; anticipating legislation; enforcing adherence to requirements; advising management on needed actions; ensures compliance with Joint Commission and other external and internal regulatory agencies.
• Maintains the integrity of confidential patient information in accordance with HIPAA and hospital policy, including accessing, using and disclosing patient information relevant to the individual employee’s job duties. Also maintains confidentiality of other customer and hospital business affairs.
• Adheres to the standards of Magruder Hospital’s corporate compliance policies and seeks guidance and training when necessary to resolve questions about the policies. Reports violations in accordance with corporate compliance and organizational standards.
• Attendance is an essential function of this position. Reports to work on time and as scheduled; Shows respect for co-workers by following established break times; Keeps personal conversations and telephone calls to a minimum.
• Travel is primarily local during the business day, although some out-of-area and overnight travel may be expected.
• Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.
• Other job duties as requested or assigned.

• High School Diploma or GED equivalent.
• Excellent typing, data entry, math, analytical, customer, stress management, organizational and problem-solving skills.
• Proficient in the use of personal computers and various types of office equipment. Has a strong working knowledge of PC based Word Processing and Spreadsheet applications, preferably Microsoft Office products (Word, Excel, Outlook).
• Ability to work in a safe and efficient manner and maintain an accident-free workplace, including ability to demonstrate a working knowledge of Magruder Hospital emergency codes.
• Strong working knowledge of departmental policies, procedures and business operations and how they interrelate to other departments in the organization.
• Strong knowledge of insurance and/or account follow-up.
• General knowledge of accounting systems and procedures.
• Must be able to see, hear, respond, and communicate efficiently to the customer, patients and to calls received. Must be able to interact efficiently with others.
• Must be detail-oriented to research accounts to determine proper payment and verify correct adjustments for accounts.
• Must have the ability to deal with constant interruptions with poise, tact, and professionalism, while maintaining a positive image for the hospital.
• Knowledge and understanding of billing form UB-04, 1500 and ICD-10 Coding.
• Knowledge of hospital and/or medical billing and insurance claim filing.
• Insurance and/or account follow-up.
• Knowledge of medical and insurance terminology.
• Participant in special workshops of training sessions in Medicare, Medicaid and non-government payers procedures to maintain a current, knowledgeable position relative to these procedures.
• Third party billing and collections
• Basic knowledge of medical and insurance terminology.
• Minimum 1 year experience in a Customer Service setting.
• 1 year hospital billing business office experience.
• Maintains a positive impression at all times.

Preferred:

• Associates Degree in Medical Billing and Coding or related field
• Knowledge of automated systems preferred

Magruder Hospital is an Equal Opportunity Employer and provides equal employment and advancement opportunities to all qualified applicants for employment without regard to race, color, religion, sex, sexual orientation, gender identify, national origin, veteran status, disability, or any other protected class under the law.

Magruder Hospital is a Tobacco and Drug Free Workplace. Any offer of employment will be contingent upon satisfactory completion of pre-employment drug screening, including screening for the presence of nicotine, satisfactory completion of background verification, and the results of a post-offer medical and physical examination.